Influenza Vaccine Recommendations for Adults

Age-Based Recommendations

The Advisory Committee on Immunization Practices (ACIP) recommends preferential use of higher-dose or adjuvanted influenza vaccines for adults 65 years and older 2
Fluzone High-Dose (HD-IIV4) is specifically licensed only for adults aged 65 years and older 1, 2
For adults under 65 years of age, standard-dose influenza vaccines are recommended 1
The high-dose influenza vaccine contains a higher amount of hemagglutinin per vaccine virus compared to standard-dose vaccines 3, 2

Fluzone High-Dose met prespecified criteria for superior efficacy compared to standard-dose influenza vaccine in a randomized trial conducted among persons aged 65 years and older 4
The Centers for Disease Control and Prevention (CDC) does not recommend high-dose influenza vaccine for adults under 65 years 1

Patients with certain medical conditions aged 18-64 years who are taking immunosuppressive medication may benefit from high-dose influenza vaccines 1, 2
Certain transplant recipients aged 18-64 years who are receiving immunosuppressive medications may also benefit from high-dose vaccines 1, 2

For a patient who has just turned 65, Fluzone High-Dose is appropriate and recommended 4, 3, 2
For patients under 65 without specific risk factors, standard-dose influenza vaccine should be used 1
Vaccination should not be delayed if only standard-dose vaccine is available, as any influenza vaccine is preferred over no vaccination 2

Administering high-dose vaccine to patients under 65 without specific medical indications is not FDA-approved and may not be covered by insurance 1, 2
Shared decision-making about vaccine choice should only occur within the context of FDA-approved indications and ACIP recommendations 4, 3, 1